Ovarian stromal luteoma in a patient with endometrial carcinoma.

A 65-year-old patient with endometrial adenocarcinoma underwent hysterectomy. Pathological examination of the right ovary revealed a coexisting stromal luteoma. The possible relationship between the two neoplasms as well as the intriguing pathogenesis and controversial nomenclature of ovarian steroid cell tumors are discussed. The incidental discovery of a stromal luteoma in a total hysterectomy specimen removed for endometrial carcinoma raises interesting questions about the perceived innocuous nature of these rare lipid cell tumors.

Clinico-pathological profile of 22 cases of cystic renal dysplasia.

Renal dysplasia is one of the major renal developmental anomaly characterized by abnormal structural organization and development of metanephric elements. It is usually detected antenatally or in early childhood. The kidney may be multicystic, aplastic, hypoplastic or duplex. We studied 22 cases of cystic renal dysplasia diagnosed over a period often years to identify the spectrum of morphological changes in dysplastic kidney, with special emphasis on mesenchymal changes. Clinical, radiological and gross morphologicalfeatures were noted. Microscopic features were studied in detail, including the epithelial and mesenchymal changes. Twenty-one of the 22 cases studied were children. One case was a 21-year-old adult, which is a rare age at presentation. Male to female ratio was 1.1:1. One of our patients had contra-lateral ureteric stenosis, a rare anomaly reported with renal dysplasia. Ten patients, all autopsy cases, had multi-system congenital anomalies. As cystic renal dysplasia is not a hereditary disease, it must be differentiated from polycystic kidney disease. Other differential diagnoses are cystic nephroma and cystic partially differentiated nephroblastoma. Histopathological examination is the final diagnostic tool since radiological features alone may not be sufficient to exclude other cystic renal lesions. Cartilage may not be seen in all cases of renal dysplasia. Once diagnosed, other associated anomalies should also be looked for.

Adenomatoid odontogenic tumor - a rare cause of jaw swelling

O tumor odontogênico adenomatóide (TOA) é um tumor incomum de origem odontogênica, caracterizado histologicamente pela formação de estruturas tubulares com depósitos do tipo amilóide. A histogênese do TOA ainda é indeterminada e este tumor é frequentemente considerado mais como uma lesão hamartomatosa do que propriamente um neoplasma. O TOA tem comportamento benigno, sendo suficiente a enucleação cirúrgica conservadora ou curetagem. Neste artigo, é descrito um caso de TOA em paciente de 15 anos do sexo feminino, que exibia um edema no lado esquerdo da mandíbula com reabsorção dental. A histopatologia revelou uma variante folicular intra-óssea do tumor odontogênico adenomatóide. Uma breve revisão da literatura é também apresentada.

Granulocytic sarcoma of the female genital tract: report of a case with an unusual presentation.

Granulocytic sarcoma of the female genital tract is a rare occurrence. A case of a perimenopausal female is presented who reported with a history of menorrhagia with a lump in the abdomen. A diagnosis of fibroid uterus was made but laparotomy findings were suggestive of inoperable ovarian malignancy with metastases. Postoperatively the patient suddenly became very anemic. Hematological investigations and histopathological reports from ovaries, myometrium, endometrium and intraperitoneal deposits all revealed acute myeloid leukemia. The patient received two cycles of chemotherapy but later succumbed to her disease. Extrauterine causes of menorrhagia should be considered before instituting definitive treatment. Preoperative induction chemotherapy may be more successful in cases of granulocytic sarcoma who tend to have a poor prognosis.

Endometrial hormone receptors in women with dysfunctional uterine bleeding.

OBJECTIVE: The objective was to study the estrogen receptor (ER) and progesterone receptor (PR) expression in endometrium of women with dysfunctional uterine bleeding (DUB) as compared to women with normal menstrual cycles. METHODS: In this study, 30 patients and 20 controls were selected. Transvaginal ultrasound and endometrial sampling for histology and ER and PR estimation immunohistochemically was carried out for all the subjects. Student's t-test and linear correlation was used for statistical analysis. Their response to treatment was assessed by clinical follow-up. RESULTS: Endometrial thickness and ER and PR levels in DUB patients were significantly higher. In cases showing hyperplastic endometria, ER and PR levels were higher than patients with normal histology. In contrast to hyperplastic tissue, steroid receptor levels decrease in hyperplastic tissue containing atypia. CONCLUSION: Altered endometrial morphology and increased receptor levels in DUB patients suggest that unopposed estrogen effect could have an important role in the pathogenesis of DUB. Cases of DUB, which showed atypical hyperplasia, may have a down-regulation of these receptors and could be a precursor lesion to carcinoma and thus do not respond to medical therapy by hormones.

Adenomatoid odontogenic tumor--a rare cause of jaw swelling.

Adenomatoid odontogenic tumor (AOT) is an uncommon tumor of odontogenic origin, characterized histologically by the formation of ductlike structures with amyloid-like deposits. Histogenesis of AOT is still uncertain and it is often considered as a hamartomatous lesion rather than a true neoplasm. AOT has a benign behavior and conservative surgical enucleation or curettage is sufficient. We report a case of AOT in a 15-year-old female who presented with left-sided jaw swelling with tooth resorption. Histopathology revealed intraosseus follicular variant of AOT. A brief review of literature is also discussed.

Leiomyomatosis peritonealis disseminata with malignant change in a post-menopausal woman.

BACKGROUND: Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by multiple subperitoneal nodules of benign smooth muscle. The lesion usually occurs in women of childbearing age. CASE: A 55-year-old woman with a history of panhysterectomy 8 years ago presented with an abdominal lump. Ultrasonographic and peroperative finding of multiple omental nodules led to a clinical impression of disseminated malignancy. Only the largest nodule was excised, histopathology of which revealed a cellular leiomyoma. Seven months later, she developed an omental leiomyosarcoma. An omentectomy was done and the multiple smaller nodules were all confirmed to be composed of benign leiomyocytes. CONCLUSION: Malignant transformation in LPD in post-menopausal patients is an exceptional event that has been documented only twice previously in English literature.

Insular carcinoma of thyroid--a case report.

Insular carcinoma of thyroid (ICT) is a rare tumor, which accounts for 4-6% of thyroid malignancies. ICT arising from follicular cells of thyroid shows a characteristic insular growth pattern characterized by solid nests of tumor cells separated by vessels. A 52-year-old female presented with a huge swelling in midline of the neck with retrosternal extension. The patient was euthyroid. Near total thyroidectomy was done. Grossly, the tumour was involving both the lobes and isthmus of thyroid. Microscopic examination revealed features of insular carcinoma. On immunohistochemistry, tumour cells were positive for thyroglobulin and negative for calcitonin.

Lymphangioma of the fallopian tube--a case report.

Lymphangioma of the fallopian tube is very rare. Only one such case has been reported. A 30-years-old female with lymphangioma of the left fallopian tube is described here. She presented with fever, vaginal bleeding and foul smelling discharge. A mass was felt in left fornix. On exploratory laparotomy, a left tubo-ovarian mass adherent to the surrounding structures was seen. Clinical diagnosis was septic abortion with adhesions. Left-sided partial tubectomy was performed. Histology of the left tube revealed large dilated channels containing lymph in the submucosa. Lymphocytes were also seen in some channels. Histogenesis of lymphangioma remains uncertain. Presence of adhesions in this case suggests a reactive origin. Histopathology is confirmatory for diagnosis.

Angiomyoma of the palate--a case report.

Leiomyomas are rare tumors of the palate amongst which angiomyomas are the commonest sub-type. Recurrence is rare and prognosis is excellent. Only a few case reports are available in literature. We report a case of angiomyoma of the palate presenting as an encapsulated swelling in the roof of the mouth.

Unilateral gestational macromastia--a rare disorder.

Macromastia is the massive enlargement of the breast, unilateral or bilateral, disproportionate to the growth of the rest of the body. It is called gravid macromastia or gigantomastia of pregnancy when it occurs during pregnancy. It may or may not regress following parturition. Gestational macromastia is exceptionally rare. We report a 28-year-old female with gigantomastia of the left breast. She presented at four months post-partum with painful massive enlargement of the left breast since the third month of pregnancy. The overlying skin was stretched out and showed multiple ulcers with foul smelling discharge. The nipple and areola were unremarkable. Simple mastectomy was done, as fine needle aspiration cytology was suggestive of phylloides tumour. The breast specimen measured 30 x 30 x 9 cm and was replaced totally by grey-white tissue involving all the resection margins. No normal breast tissue or fat was identified. Histopathology showed periductal as well as diffuse fibrosis, adenosis and lactational changes. No features of phylloides tumour or carcinoma were present and it was diagnosed as unilateral gestational macromastia.

Longitudinal nail biopsy: utility in 20-nail dystrophy.

BACKGROUND: Twenty-nail dystrophy (TND) is an inflammatory disorder of the nail unit. It is frequently encountered in childhood and is believed to be a common clinical manifestation of several nail pathologies. Varying associations and histopathologic features have been reported previously. OBJECTIVES: To evaluate the clinical and histopathologic profile of TND and the utility of longitudinal nail biopsy (LNB) for the same. METHODS: Thirty-two consecutive patients with TND were screened clinically. The histopathologic features of skin and longitudinal nail biopsies were also evaluated. The efficacy of nail unit biopsy was thereby assessed. RESULTS: Young males in the 10- to 20-year-old age group were most commonly affected (52%). Alopecia areata was the most commonly associated dermatosis (22%). LNB revealed a specific diagnosis of either psoriasis or lichen planus in 52% of the cases, whereas the rest showed nonspecific histologic changes (spongiotic trachyonychia). Scarring was a major risk associated with LNB, as evident in 28% of the patients studied. CONCLUSIONS: These data reveal the clinical profile and common associations of TND. They also confirm the diagnostic utility of nail biopsy in TND patients and advocate this procedure in cases in which the clinical diagnosis is otherwise obscure. However, it cannot be recommended in the routine evaluation of patients with a relatively benign disorder such as TND. Furthermore, nail biopsy is proven to be a relatively simple and useful procedure.

Congenital cervical teratoma--an unusual presentation.

We report a case of congenital benign cervical teratoma in a female child. The unusual asymptomatic nature of the tumour and its relationship with the thyroid is highlighted.

Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid--a case report.

We report a 55-year old female who presented with thyroid swelling for six months. She was clinically asymptomatic with normal thyroid functions. Thyroidectomy revealed the left lobe totally replaced by a well-circumscribed grey white homogenous tumor. Microscopically, the tumor comprised of cells arranged in adenoid pattern along with nests of cohesive intermediate cells, some also forming keratin pearls in a sclerotic and inflammatory background. The thin rim of thyroid at the periphery showed features of lymphocytic thyroiditis. No other associated malignancy was seen on thorough screening. The tumor cells were negative for thyroglobulin and calcitonin. The patient was thus diagnosed with Sclerosing mucoepidermoid carcinoma with eosinophilia, thyroid.

Neurilemmoma of tongue.

Neurilemmoma is usually soimry, benign tumour derived from schwan cells of the Sheaths of peripheral cranial or autonomie nerves. In thehead and neck region it occurs most commonly in association with acoustic nerve within the skuil and is rely fottnd in the oral cavity (1,2). We report here two cases of the iongue diagnosed on histopathohgy.